Outpatient services are increasingly recognised as an important component of health care provision and may be improved through the application of modern management techniques. We have performed a time and role audit of consultation and waiting times in two medical clinics using different queuing systems: namely, a serial processing clinic where patients wait in a single queue and a quasi-parallel processing clinic where patients are directed to the shortest queue to maintain clinic flow. Data collected were used to construct a (...) computer simulation of patient flows in clinic. Assessment of patient satisfaction in the clinic process was determined using a self-administered questionnaire. Mean waiting time was shorter in the quasi-parallel processing clinic: 26 (SD 17) minutes compared with 36(24) minutes in the serial processing clinic. In the serial processing clinic 61% of patients waited more than 30 minutes compared with 41% in the quasi-parallel processing clinic. In the serial processing clinic 8% of 142 patients surveyed complained of the time spent waiting. The computer simulation we produced was able to determine waiting times with different clinic structures. The simulation showed that reductions in waiting time up to 30% might be achieved by changing our serial processing clinic to a quasi-parallel processing one. Performance of medical outpatient clinics can be improved by examining and changing clinic management. Computer simulation of outpatient clinics offers a means of assessing the impact of such changes on waiting time in clinic and on waiting lists. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:If “Reality is the Best Metaphor,” It Must Be VirtualMarguerite R. Waller (bio)What is the search for the next great compelling application but a search for the human identity?—Doug Coupland, Microserfs... we can look forward to a richly textured and complex cyberspace, where we are at all times human, and can become bits of pixel dust flying through a virtual landscape.—3-D, multiuser, interactive, on-line virtual reality producer“Avatars are Next,” (...) the June 1996 issue of Wired announces on its cover, above a glossy foldout of Bill Gates in bathing trunks floating on a lemon yellow air mattress in a sensuous Hockney-blue swimming pool. “Mr. Bill goes Hollywood! Special Gatesfold Issue,” reads the caption underneath the (photomontaged) naked torso. The United States Congress’s attempt in February 1996 to conceptualize the Internet as an incitement to indecent sexual conduct (in Section 507 of the 1996 Telecommunications Act, the so-called Computer Decency Act) is clearly the lampooned subtext of this juxtaposition of sexualized body with the concept of the avatar. The antithesis of sensuous, avatars are bandwidth-conserving, virtual figures that take the place of users’ physical bodies in the three-dimensional, interactive, multiuser virtual environments that software developers in 1996 insist will be the telos of the development of the World Wide Web. The Wired cover implies that the nerd community finds Congress’s association of digital media with sex ridiculous (however flattering they may find it to be constructed as sexually dangerous). Not unusually, sexuality is being invoked by the state as a justification for extending its own reach (and the corporate interests it represents).But the sex/gender politics of Net free speech advocates are not necessarily more progressive. As feminist commentator Laura Miller argues in “Women and Children First: Gender and the Settling of the Electronic Frontier,” the metaphor of a frontier beyond the jurisdiction of Congress, deployed by opponents of federal regulation, draws upon a conventional construction of gender that threatens to reinscribe women as victims, reinforcing “the power imbalance between the sexes, with its roots in the concept of women as property, constantly under siege and requiring the vigilant protection of their male owners” [53]. The unintended consequence of this conceptualization, she worries, is that “the threat of regulation is built into the very mythos used to conceptualize the Net by its defenders” [50].My worry, therefore, embraces both sides of the debate over free speech on the Net. The skirmish between Big Brother and the software pioneers seems to be shaping up rhetorically as a classic fraternal competition “between men” (Sedgwick). We may read it as a contest between fundamentally congruent “male” subject positions, both of which incline to disempower “female” subject positions and both of which stand to increase their [End Page 90] own political and economic capital by the appearance of a conflict. The power-producing relationality at play in this turf war, however, simultaneously threatens to subvert the claims of each position to its own, independent ontology. Both parties, therefore, can be expected compulsively to deny their relational status. John Perry Barlowe insists, in his “Declaration of Independence in Cyberspace”: “Your legal concepts of property, expression, identity, movement, and context do not apply to us. They are based on matter. There is no matter here.”It is this more subtle metaphysical issue, the occlusion of relation, implicated in but not reducible to, the constructions of sexuality and gender deployed by both Netizens and Congresspeople, that I find the most pressing issue in designs, uses, and discussions of cyberspace. I will argue that, in fact, the current wave of Internet development (both practically and discursively) is in some sense driven by a desire to make cyberspace safe for essentialist subjectivities of whatever ideological/political persuasion. I will unfold this argument in terms of a certain notion of addiction. My interest is not “cyberaddiction” per se, in the sense of individuals who spend what they or their associates consider too much time on-line, but rather the construction of cyberspace—both rhetorically and electronically—as a clean, clear realm in which we can transcend positionality while remaining (or becoming more fully) “ourselves.” I am not, that... (shrink)

No word in English is shorter than the word I.' And yet no word is more important in philosophy. When Descartes said I think therefore I am' he produced something that was both about himself and a universal formula. The word I' is called an indexical' because its meaning always depends on who says it. Other examples of indexicals are you,' here,' this' and now.' John Perry discusses how these kinds of words work, and why they express important (...) philosophical thoughts. He shows that indexicals pose a challenge to traditional assumptions about language and thought. Over the years a number of these papers, now included in this book, have sparked lively debates and have been influential in philosophy, linguistics and other areas of cognitive science. With seven new papers, including the previously unpublished What Are Indexicals?,' the present volume expands on an earlier version of this book published in the early nineties. Also included are the well-known papers Frege on Demonstratives,' Cognitive Significance and New Theories of Reference,' Evading the Slingshot,' The Prince and the Phone booth', Fodor on Psychological Explanations', and related papers on situation semantics, direct reference, and the structure of belief. This book also includes afterwords written by the author that discuss responses to his work by Gareth Evans, Robert Stalnaker, Barbara Partee, Howard Wettstein and others. (shrink)

RECENT STUDIES OF CHRISTIANITY'S RELATION TO LIBERAL POLITICS HAVE recognized the importance of specifying clearly what type of liberalism is being considered. Jeffrey Stout's critique is one such example. Unfortunately, Stout fails to engage the one thinker who arguably is the most influential in how Americans relate Christianity and politics: John Locke. Political arguments of today's Christians are premised, often unconsciously, on rival interpretations of Locke's political theology.

John Perry revisits the cast of characters of his classic _A Dialogue on Personal Identity_ and Immortality in this absorbing dialogue on consciousness. Cartesian dualism, property dualism, materialism, the problem of other minds... Gretchen Weirob and her friends tackle these topics and more in a dialogue that exemplifies the subtleties and intricacies of philosophical reflection. Once again, Perry’s ability to use straightforward language to discuss complex issues combines with his mastery of the dialogue form. A Bibliography lists (...) relevant further readings keyed to topics discussed in the dialogue. A helpful Glossary provides a handy reference to terms used in the dialogue and an array of clarifying examples. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Avatars of the Word: From Papyrus to CyberspaceJay David BolterJames J. O'Donnell. Avatars of the Word: From Papyrus to Cyberspace. Cambridge: Harvard University Press, 1998. xiv + 210 pp. 1 ill. Cloth, $24.95.The last chapter of James O'Donnell's thoughtful and highly readable book is entitled "Cassiodorus: Or, The Life of the Mind in Cyberspace." The subtitle made me think of the cyberenthusiast John Perry Barlow's (...) claim that cyberspace is in fact the new home of Mind. In a brief tract published on the Internet a few years ago, "A Declaration of Independence for Cyberspace," Barlow claimed that cyberspace is a new world, freed from the prejudices and traditions of the cultures of our physical world. Barlow is in many ways O'Donnell's opposite number. Where Barlow, like so many other proponents of cyberspace, rejects the relevance of history for our electronic future, O'Donnell anchors every step of his analysis in the history of writing. Where Barlow is frenetic, O'Donnell is calm. O'Donnell considers electronic writing as the latest in a series of technologies of writing, each responding to and shaped by its contemporary culture. The main lines of O'Donnell's argument--his comparison of contemporary literate culture to earlier cultures of the papyrus roll, the codex, and the printed book--are familiar from other sources. But O'Donnell's profound and easy learning enables him to add fresh insights and examples on every issue.O'Donnell's strategy is to explain the meaning of electronic writing today through a series of historical resonances. Early chapters examine the passage from orality to literacy as represented by the contrasting philosophical presences of Socrates and Plato; the changing nature of the library from the Alexandrian through Cassiodorus and the medieval monastic library and on to the hopes for today's "virtual" library; and the techniques of reading and reference [End Page 334] afforded by various technologies from the papyrus roll to the codex to the homepage. In later chapters O'Donnell explores the nature of teaching and of the university today and speculates on their future, as electronic technologies become more important to the curriculum. His specialist's knowledge of late antiquity and the early Middle Ages permits him to concentrate on this crucial period, which witnessed the shift from papyrus roll to codex. The historian of the book Roger Chartier has also argued that this transfer from roll to codex is the most appropriate comparison for the current move from printed book to electronic text. O'Donnell devotes relatively little space to discussing the latest avatar, electronic technology itself; he concentrates instead on establishing the historical parallels.In short, what is usually lacking in discussions of electronic writing, an informed historical sense, is in ample supply in Avatars of the Word. O'Donnell is in general optimistic about the future of literate culture. His optimism seems to come precisely from his long historical view, which mitigates any feeling of panic over the current changes in the forms and practices of literacy. In this respect we might compare his cautious optimism with the less informed pessimism of Sven Birkerts in his Gutenberg Elegies (1994). O'Donnell is also sanguine about the role that electronic technology can play in education--not by replacing teachers, but rather by allowing instruction to become more individual.On the other hand, the historical sophistication of Avatars of the Word both defines and limits its audience. Enthusiasts like John Perry Barlow count their readers in the hundreds of thousands, precisely because they offer a high-energy narrative of the future that does not trouble itself about the past. The leisurely and reflective pace of O'Donnell's book will seem luxurious to most of the new media world. O'Donnell says that his audience are "those who read books and use computers and wonder about the relationship" (ix). But the audience is perhaps narrower: those who, like the readers of this journal, are steeped in literate culture. Even within that group, O'Donnell is really speaking to those who are not intimidated by or disdainful of computer technology.In addition to being a professor of... (shrink)

A collection of twelve essays by John Perry and two essays he co-authored, this book deals with various problems related to "self-locating beliefs": the sorts of beliefs one expresses with indexicals and demonstratives, like "I" and "this." Postscripts have been added to a number of the essays discussing criticisms by authors such as Gareth Evans and Robert Stalnaker. Included with such well-known essays as "Frege on Demonstratives," "The Problem of the Essential Indexical," "From Worlds to Situations," and "The (...) Prince and the Phone Booth" are a number of important essays that have been less accessible and that discuss important aspects of Perry's views, referred to as "Critical Referentialism," on the philosophy of language and the philosophy of mind. (shrink)

Following his recently expanded _The Problem of the Essential Indexical and Other Essays,_ John Perry develops a reflexive-referential' account of indexicals, demonstratives and proper names. On these issues the philosophy of language in the twentieth century was shaped by two competing traditions, descriptivist and referentialist. Oddly, the classic referentialist texts of the 1970s by Kripke, Donnellan, Kaplan and others were seemingly refuted almost a century earlier by co-reference and no-reference problems raised by Russell and Frege. Perry's theory, (...) borrowing ideas from both traditions as well as from Burks and Reichenbach, diagnoses the problems as stemming from a fixation on a certain kind of content, coined referential or fully incremental. Referentialist tradition is portrayed as holding that indexicals contribute content that involves individuals without identifying conditions on them; descriptivist tradition is portrayed as holding that referential content does not explain all of the identifying conditions conveyed by names and indexicals. Perry reveals a coherent and structured family of contents — from reflexive contents that place conditions on their actual utterance to fully incremental contents that place conditions only on the objects of reference — reconciling the legitimate insights of both traditions. (shrink)

In this book, renowned philosopher John Perry addresses critiques of his work on the essential indexical.

A defense of antecedent physicalism, which argues against the idea that if everything that goes on in the universe is physical, our consciousness and feelings ..

This volume tackles the slippery subject of 'meaning'.

John Perry offers a rethinking of Frege's seminal contributions to philosophy of language, which had a dominant influence on the subject in the twentieth century. He argues that Frege's famous doctrine of indirect reference led philosophers on a detour, and he advocates a move to a new framework for understanding reference.

John Perry connects the 'Johannine liberalism' of Locke and Rawls to contemporary debates about the place of religion in public life, arguing that disputes such as the culture wars must be understood theologically as fundamental conflicts of loyalty.

Perry argues that certain sorts of indexicals are 'essential', in the sense that they cannot be eliminated in favor of descriptions. This paper also introduces the influential idea that certain sorts of indexicals play a special role in thought, and have a special connection to action.

A new collection of John Perry's work celebrating his contributions to the philosophy of language.

John Perry--author of the acclaimed _Dialogue on Personal Identity and Immortality_ --revisits Gretchen Weirob in this lively and absorbing dialogue on good, evil, and the existence of God. In the early part of the work, Gretchen and her friends consider whether evil provides a problem for those who believe in the perfection of God. As the discussion continues they consider the nature of human evil—whether, for example, fully rational actions can be intentionally evil. Recurring themes are the distinction (...) between natural evil and evil done by free agents, and the problems the Holocaust and other cases of genocide pose for conceptions of the universe as a basically good place, or humans as basically good beings. Once again, Perry’s ability to get at the heart of matters combines with his exemplary skill at writing the dialogue form. An ideal volume for introducing students to the subtleties and intricacies of philosophical discussion. (shrink)

Contents PART I: INTRODUCTION 1 John Perry: The Problem of Personal Identity, 3 PART II: VERSIONS OF THE MEMORY THEORY 2 John Locke: Of Identity and ...

When you use the word “I” it designates you; when I use the same word, it designates me. If you use “you” talking to me, it designates me; when I use it talking to you, it designates you. “I” and “you” are indexicals. The designation of an indexical shifts from speaker to speaker, time to time, place to place. Different utterances of the same indexical designate different things, because what is designated depends not only on the meaning associated with the (...) expression, but also on facts about the utterance. An utterance of “I” designates the person who utters it; an utterance of “you” designates the person to whom it is addressed, an utterance of “here” designates the place at which the utterance is made, and so forth. Because indexicals shift their designation in this way, sentences containing indexicals can be used to say different things on different occasions. Suppose you say to me, “You are wrong and I am right about reference,” and I reply with the same sentence. We have used the same sentence, with the same meaning, but said quite different and incompatible things. (shrink)

In this paper, I shall defend Russell's view that Mont Blanc, with all of its snow elds, is a component part" or constituent of what is actually asserted when one utters Mont Blanc is more than 4000 meters high," and of what one believes, when one believes that Mont Blanc is 4000 meters high. I also claim, however, that a proposition that does not have Mont Blanc as a constituent plays an important role in the assertion and the belief that (...) Mont Blanc is more than 4000 meters high. Taken somewhat out of context, the quotes from Frege and Russell express insights that pull in di erent directions in the contemporary philosophy of language. Behind Frege's remark is the insight that reference is not direct but mediated. When we think and talk about things, our thoughts and words are not in direct contact with the things thought about and talked about. The meanings of our words, and the cognitive roles of our ideas, do not in and of themselves determine their reference. They get at objects via some aspects of.. (shrink)

Philosophers and logicians use the term “indexical” for words such as “I”, “you” and “tomorrow”. Demonstratives such as “this” and “that” and demonstratives phrases such as “this man” and “that computer” are usually reckoned as a subcategory of indexicals. (Following [Kaplan, 1989a].) The “context-dependence” of indexicals is often taken as a defining feature: what an indexical designates shifts from context to context. But there are many kinds of shiftiness, with corresponding conceptions of context. Until we clarify what we mean by (...) “context”, this defining feature remains unclear. In sections 1–3, which are largely drawn from [Perry, forthcoming(a)], I try to clarify the sense in which indexicals are context-dependent and make some distinctions among the ways indexicals depend on context. In sections 3–6, I contrast indexicality with another phenomenon that I call “unarticulated constituents.”. (shrink)

”Self-beliefs” are beliefs of the sort one ordinarily has about oneself, and expresses with the first person. These contrast with the beliefs one has in ”Casta˜neda cases,” in which one has a belief about oneself without knowing it. This paper advances an account of the nature of self-belief. According to this account, self-belief is a special case of interacting with things via notions that serve as repositories for information about objects with certain important relations to the knower, and as motivators (...) for actions the success of which is dependent on the object in that relation to the agent. Identity is such a relation, and ”self-notions” play this special role: they are the repositories for information gained in normally self-informative ways, and the motivators of types of action whose success normally depends on facts about the agent. Self-beliefs involve such self-notions, while the beliefs that one has about oneself in Casta˜neda cases do not. (shrink)

This paper examines the argument that moral approval of homosexuality is analogous to the early church's inclusion of gentiles. The analogy has a long but often overlooked history, dating back to the start of the modern gay-rights movement. It has recently gained greater prominence because of its importance to the Episcopal Church's debate with the wider Anglican Communion. Beginning with the Episcopal Church argument, we see that there are five specific areas most in need of further clarification. In this essay (...) I examine significant uses of the analogy from the prior 25 years to see how effectively they address these five areas. I conclude that the conversation surrounding the Gentile Analogy is the current, best hope for mutual understanding among Christians about homosexuality. However, if the analogy is to advance the Christian conversation, much greater care and precision is needed in its application from traditionalists and revisionists alike. (shrink)

My aim in this study is not to praise Fischer's fine theory of moral responsibility, but to (try to) bury the “semi” in “semicompatibilism”. I think Fischer gives the Consequence Argument (CA) too much credit, and gives himself too little credit. In his book, The Metaphysics of Free Will, Fischer gave the CA as good a statement as it will ever get, and put his finger on what is wrong with it. Then he declared stalemate rather than victory. In my (...) view, Fischer’s view amounts to sophisticated compatibilism. It would be nice to be able to call it by its right name. In The Metaphysics of Free Will, Fischer develops his own version of Consequence Argument, which turns on two principles, one of which is the fixity of the past. FP: For any action Y, agent S and time t, if it is true that is S were to do Y at t, some fact about that past relative to t would not have been a fact, then S cannot at t do Y at t. I argue that the equipment needed to reject FP (and thereby defend the most plausible version of compatibilism) is needed to deal with the problem of fatalism. In addition, I argue that the rejection of FP is compatible with Fischer’s approach to Frankfurt cases and with his account of transfer principles. (shrink)

Demonstratives seem to have posed a severe difficulty for Frege’s philosophy of language, to which his doctrine of incommunicable senses was a reaction. In “The Thought,” Frege briefly discusses sentences containing such demonstratives as “today,” “here,” and “yesterday,” and then turns to certain questions that he says are raised by the occurrence of “I” in sentences (T, 24-26). He is led to say that, when one thinks about oneself, one grasps thoughts that others cannot grasp, that cannot be communicated. However, (...) nothing could be more out of the spirit of Frege’s account of sense and thought than an incommunicable, private thought. In the first part of the paper, I explain the problem demonstratives pose for Frege, and explore three ways he might have dealt with it. I argue that none of these ways provides Frege with a solution to his problem consistent with his philosophy of language. The first two are plausible as solutions, but contradict his identification of the sense expressed by a sentence with a thought. The third preserves the identification, but is implausible. In the second part, I suggest that Frege was led to his doctrine of incommunicable senses as a result of some appreciation of the difficulties his account of demonstratives faces, for these come quickly to the surface when we think about “I.” I argue that incommunicable senses won’t help. I end by trying to identify the central problem with Frege’s approach, and sketching an alternative. (shrink)

This is a volume of philosophical studies, centred on problems of personal identity and extending to related topics in the philosophy of mind and moral philosophy.

Frege continues by explaining what bothered him in the Begriffsschrift, and motivated his treatment of identity in that work.2 He goes on to criticize that account. By the end of the paragraph, he has introduced his key concept of sinn, abandonning not only the Begriffsschrift account of identity, but its basical semantical framework. In the Begriffsschrift Frege’s main semantic concept was content [Inhalt ]. Already in the Begriffsschrift, he is struggling with this concept. In §3 he..

The debate among American evangelicals over scriptural inerrancy has received less attention in recent literature than it did during its height in the 1970s and 1980s. Nonetheless the issue itself remains unresolved; indeed, many consider it beyond hope of resolution. Recent work by certain philosophers, however, suggests that there is a way out-not by resolving the debate but by dissolving it. In particular, a model developed by Nancey Murphy for understanding the history of the split between Protestant liberals and conservatives (...) can be appropriated for understanding the history of the inerrancy debate. Examining the history of this debate through the postmodern lens of Murphy's model reveals that certain shortcomings of modern philosophy fed into the debate, forcing theologians to overstate the significance of certain claims. As the debate progressed, there was a steadily increasing concern that Scripture be considered accurate in all matters, including the precise recording of detailed historical events and matters of science. For some conservatives this eventually became a test of orthodoxy; that theologians such as Martin Luther and John Calvin did not share this view reveals the force of modernity's influence. Looking beyond the current evangelical view of Scripture, a postmodern world provides room for an even stronger commitment to the Bible's authority, though one that does challenge certain evangelical assumptions. (shrink)

This chapter explores the notion of some philosophers that the self is a mysterious thing. It has been associated with a number of concepts, such as the souls of Christian theology, the essential natures that are passed along in reincarnation, or as noumenal objects that exist beyond normal space and time, outside of the causal realm, and join, in some Kantian way, with the primordial structure of reality to create the world as we know it. Hume, on the other hand, (...) believes that a bundle of perceptions serves as the self. This leads to two thoughts regarding the self: Hume’s bundle theory and the self as a person, thought of under the relation of identity. This chapter will delve into these two thoughts. (shrink)

En este libro, John Perry elabora una teoria "reflexivo-referencial" de los indexicos, los demostrativos y los nombres propios. La Filosofia del Lenguaje del siglo veinte se vio condicionada por dos tradiciones enfrentadas en torno a esos temas: el descriptivismo y el referencialismo. Los textos referecialistas clasicos de, entre otros, Saul Kripke, Keith Donnellan y David Kaplan son de los anos 70. Curiosamente, parece que ya habian sido refutados casi un siglo antes por los problemas de co-referencia y no-referencia (...) planteados por Frege y Russell. La teoria de Perry, que toma prestadas ideas de ambas tradiciones asi como de Burks y Reichenbach, situa el origen de los problemas en la atencion exclusiva a un tipo de contenido: el contenido llamado referencial o completamente incremental. La tradicion referencialista se caracteriza por la tesis de que los indexicos proporcionan un contenido que involucra a individuos pero no a sus condiciones de identificacion. La tradicion descriptivista se caracteriza por la tesis de que el contenido referencial no explica todas las condiciones de identificacion que ofrecen los nombres y los indexicos. Perry nos propone una familia coherente y estructurada de contenidos -desde contenidos reflexivos que imponen condiciones a la proferencia hasta contenidos completamente incrementales que ponen condiciones solo a los objetos de la referencia-que sirve para reconciliar lo mejor de ambas tradiciones. Book jacket. (shrink)